title: Lincosamide resistance mediated by lnu(C) (L phenotype) in a Streptococcus anginosus clinical isolate.
abstract: OBJECTIVE
  Unique resistance to lincosamides (L phenotype) due to the production of nucleotidyltransferases (Lnu) is uncommon among Gram-positive bacteria. The aim of the study was to characterize the L phenotype in a clinical isolate of the Streptococcus milleri group.
  
  
  METHODS
  The strain UCN93 was recovered from neonatal specimens and from the mother's vaginal swab. Identification was confirmed by sequencing of the sodA gene. Antimicrobial susceptibility testing was carried out by the disc diffusion method, while MICs were determined using the agar dilution method. Screening for lnu(A), lnu(B), lnu(C) and lnu(D) genes was performed by PCR. Genetic environment and support were determined by thermal asymmetric interlaced PCR and PCR mapping. The transfer of lincomycin resistance was also attempted by conjugation.
  
  
  RESULTS
  UCN93 was unambiguously identified as Streptococcus anginosus. It was susceptible to all tested antibiotics, except lincomycin (MIC, 8 mg/L) and tetracycline (2 mg/L). The lnu(C) gene was found to be responsible for the L phenotype. It was shown that lnu(C) was associated with a gene coding for a transposase within a structure similar to the transposon MTnSag1, described once in Streptococcus agalactiae. Since MTnSag1 was found to be mobilized by Tn916 and S. anginosus UCN93 harboured a Tn916 transposon, several attempts at transfer were performed but they all failed. The lnu(C)-containing genetic element was inserted into a chromosomal intergenic sequence of S. anginosus.
  
  
  CONCLUSIONS
  Since lnu(C) has been detected in only one S. agalactiae clinical isolate so far, this is its second description among clinically relevant streptococci.
authors.affiliation: CHU de Caen, Service de Microbiologie & CNR de la Résistance aux Antibiotiques (laboratoire associé 'entérocoques et résistances particulières des bactéries à Gram positif'), F-14033 Caen, France.
authors.forename: François
authors.initials: F
authors.lastname: Gravey
authors.forename: Sébastien
authors.initials: S
authors.lastname: Galopin
authors.forename: Nathalie
authors.initials: N
authors.lastname: Grall
authors.forename: Michel
authors.initials: M
authors.lastname: Auzou
authors.forename: Antoine
authors.initials: A
authors.lastname: Andremont
authors.forename: Roland
authors.initials: R
authors.lastname: Leclercq
authors.forename: Vincent
authors.initials: V
authors.lastname: Cattoir
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001426:Bacterial Proteins / Q000235:genetics*; D003227:Conjugation, Genetic; D004269:DNA, Bacterial / Q000235:genetics; D024881:Drug Resistance, Bacterial; D022761:Gene Transfer, Horizontal; D006801:Humans; D007231:Infant, Newborn; D055231:Lincosamides / Q000494:pharmacology*; D008826:Microbial Sensitivity Tests; D009035:Mothers; D010641:Phenotype; D016133:Polymerase Chain Reaction; D013290:Streptococcal Infections / Q000382:microbiology*; D034366:Streptococcus anginosus / Q000187:drug effects* / Q000235:genetics* / Q000302:isolation & purification
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D004269:DNA, Bacterial; D055231:Lincosamides; C502938:lnu(C) protein, Streptococcus agalactiae
keywords: MLS resistance; S. anginosus; Streptococcus milleri group; lincomycin; lnu(C)